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By Kathryn Mayer

Forget all the other drivers of health care costs. There’s one that’s often overlooked: Consumers who don’t follow doctor’s orders — at least in terms of prescription drugs. And the lack of adherence is costing the country billions.

MediSafe — a company behind a free mobile app that lets users track their medication usage and guidelines online — collected data from 1.7 million individual medication consumption cases across the country.

Their analysis found that 10 cities lead the way in driving up health care costs each year from prescription non-adherence — including costs from avoidable hospitalizations, nursing home admissions and premature deaths.
10. Atlanta

Atlanta is one major city driving up health care costs. According to a study by the National Community Pharmacists Association, non-adherence adds $290 billion to overall health care spending annually.
9. Washington, D.C.

According to the Kaiser Family Foundation, Washington, D.C., also has the highest annual overall medical expenditure average in the country. (Insert political joke here.)
8. San Antonio

MediSafe’s study also looked at which age groups are most responsible when it comes to following prescription guidelines. Individuals from the ages of 20 to 30 are the worst at following prescription guidelines, while the oldest age block measured, ages 70 to 79, tested the best.
6. Houston

A third Texas city is in the top 10 list.

Texas also fares badly on other health numbers: It has the highest rate of uninsured residents in the country. According to Gallup-Healthways, 28.8 percent of adult Texans lacked health coverage in 2012.
5. Philadelphia

Adherence to therapy is especially important for management of chronic diseases, such as diabetes, heart disease and cancer, experts say.

According to a study from the Journal of General Internal Medicine, nearly 30 percent of patients failed to fill a new prescription and that new prescriptions for chronic conditions such as high blood pressure, diabetes, and high cholesterol were not filled 20 percent to 22 percent of the time.
4. Phoenix

According to the National Community of Pharmacists Association, even among chronically ill patients who regularly fill their prescriptions, only about half of the doses taken are taken correctly, as intended by a physician.
3. Baltimore

Nonadherence to needed medicines takes many forms.

While the most common is simply forgetting to take a prescribed medicine, almost one-third of patients stop taking their medicine earlier than instructed, according to the American Heart Association. Overall, nearly 75 percent of adults are nonadherent in one or more ways, such as not filling a new prescription or taking less than the dose recommended by the physician.
2. Brooklyn, N.Y.

Research shows that interventions such as pharmacist counseling are cost-effective and contribute to improved adherence behavior, highlighting the "central role that pharmacists and other health care professionals can play" in helping patients effectively managing chronic diseases.
1. Fort Lauderdale, Fla.

Fort Lauderdale, Fla. is the worst offending city in terms of medication non-adherence.